Natural history and genetics of human aortic disease: Individualized risk stratification and indication of treatment

• Applicant: Dr. Sven Peterß
• Subject Area: Cardiac and Vascular Surgery
• Term: from 2013 to 2016
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 245404547

Surgical treatment of the life-threatening diseases of the thoracic aorta has become significantly safer as a whole and is ascribed to the clinical and technical advances in cardiac surgery in recent decades. Despite these advances, a significant surgical risk remains for the individual patient. The risk assessment according to current science is primarily empirical. Apart from acute life-threatening aortic rupture or dissection that require immediate intervention, the indication to surgically intervene is solely based on absolute aortic diameters or the increase in diameter. As a result of the current insufficient data the various professional societies offer divergent treatment recommendations.To offer improved and inter-individual risk stratification the understanding of pathophysiology and natural disease progression of aortic diseases is crucial. As part of this research fellowship a large patient population is available to investigate the underlying pathophysiology of aortic diseases. In addition to retrospective and prospective clinical analysis of long-term disease progression alternative imaging modalities will be used to elucidate the biomechanical stress properties of the diseased aorta sustained from pathological blood flow profiles, as well as to elucidate metabolic processes within the aortic wall. Molecular genetic analyses will bring not only insights into the genetics and familial inheritance of aortic diseases, but also deliver potential biomarkers that may be helpful in determining the optimal treatment strategy. The aim of the project is to develop strong criteria that aid in the decision-making process for or against surgical treatment, to implement these in routine clinical practice and thus to allow a patient-adapted therapy recommendation and risk stratification.

• DFG Programme: Research Fellowships
• International Connection: USA
• Host: Professor Dr. John A. Elefteriades